Easily implement data analysis and decision support for cost of care management

SMR is the ideal platform for cost of care reduction initiatives. In the human service arena, SMR supports data driven level of service recommendations by employing assessment automation and decision support tools.

In hospital settings, SMR can be used with basic assessment models to create rule driven level of care decisions and post hoc reviews across case data with a minimum of data entry.

 

Using Data to Drive Level of Service Standardization

A critical component of controlling costs is to guide and monitor level of service decisions at the point of admission. By using standard tools, either from industry experts or from internal guidelines, an organization can, at a minimum, justify expenditure levels and ideally guarantee that care decisions are made in accordance with organizational policy and industry norms and regulations.

The process of assessing patients to guide level of care decisions has shown benefit in multiple settings. In the State of Illinois, administration of a standardized, proven industry assessment is credited with decreasing admissions to service and foster care by thousands of children in just a few years and saving up to 80 million dollars.

The health care and social service world is increasingly being required to either comply with level of care standards or justify level of service decisions post hoc. By having data on those decisions from standardized protocols, an organization can make better decisions and justify those decisions.

This is not a mechanical process or a replacement for human skill and judgment. Rather, it is a way of guiding the decision maker and confirming factors that are critical for a class of decisions, and for documenting justification.

Assessment can also prepare clinicians and case managers to anticipate future issues related to level of care. For example, patients who are likely to be readmitted to the hospital or an institution can be evaluated based either on organizational risk assessments or standardized tools to support clinician judgment relative to readmission. By using these techniques a clinician can work to determine strategies that will lessen future readmission risk.

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